=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467506923
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PERKINS PHARMACIES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/22/2007
-----------------------------------------------------
Last Update Date | 01/17/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2520 NORTH MAIN STREET
-----------------------------------------------------
City | NO LITTLE ROCK
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72114
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-758-7581
-----------------------------------------------------
Fax | 501-758-8503
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2520 NORTH MAIN STREET
-----------------------------------------------------
City | NO LITTLE ROCK
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72114
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-758-7581
-----------------------------------------------------
Fax | 501-758-8503
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER PHARMACIST
-----------------------------------------------------
Name | DR. TERRY W PERKINS
-----------------------------------------------------
Credential | PHARMD
-----------------------------------------------------
Telephone | 501-758-7581
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number | AR18966
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------